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[Acyclovir and pregnancy: current aspects].

J Haddad1, J Messer, D Willard

  • 1Service de Néonatologie, CHU Hautepierre, Strasbourg.

Journal De Gynecologie, Obstetrique Et Biologie De La Reproduction
|January 1, 1989
PubMed
Summary
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Acyclovir (ACV) is an antiviral effective against herpes viruses. While not typically recommended in pregnancy, this review suggests ACV may be beneficial for severe maternal infections or in utero VZV inhibition, with no observed adverse effects in newborns.

Area of Science:

  • Pharmacology
  • Virology
  • Obstetrics

Context:

  • Acyclovir (ACV) is an antiviral nucleoside analog active against Herpes simplex viruses (HSV1, HSV2) and varicella virus (VZV).
  • These viruses pose risks to pregnant women and fetuses, yet ACV is generally not recommended during pregnancy.
  • Despite contraindications, ACV has been administered in specific clinical situations during pregnancy.

Purpose:

  • To review the pharmacokinetics and transplacental passage of Acyclovir (ACV).
  • To evaluate the indications for ACV use in pregnancy.
  • To determine if the benefits of ACV administration in pregnancy outweigh potential risks.

Summary:

  • ACV crosses the placenta, with cord blood levels potentially effective for inhibiting in utero viral replication.

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  • Pregnant women may have lower peak ACV plasma concentrations than non-pregnant adults, but these levels appear effective.
  • No adverse effects were observed in newborns exposed to ACV in utero, though caution regarding nucleic acid metabolism is advised.

    • Impact:

    • ACV can be considered for pregnant women with severe viral infections or for in utero VZV inhibition.
    • Recommended dosages include intravenous administration (5-15 mg/kg/8 hours) or oral (200 mg 5 times daily).
    • This review provides evidence supporting the judicious use of ACV in specific high-risk pregnancies.